Help With NG (nasogastric) tube placement and removal


Addison, IL
Best answers
I posted this same question in the "General" Forum but thought I may get a better answer in the GI Forum.

I have a question regarding NG tube placement and removal.

We had one of our GI dr. called in to the ICU to assist with a pt. GI dr. then "inserted a 18Fr NG tube into the stomach under endoscopic guidance". Later on that same day, another one of our GI Drs. then came in and removed that same NG tube. The documentation is as follows: An NG tube was seen in the esophagus and proximal stomach with clotted blood within it. NG was removed. Small amount of red blood seen was suctioned without bleeding. Mild NG trauma with erosions seen at UES and GE junction, no bleeding from this. Otherwise the upper third of the esophagus, middle third of the esophagus and lower third of the esophagus were normal.

Our question is....what do you code for NG tube removal?
We have had a couple of different answers such as 43247 - for removal of foreign body or just to code a regular EGD 43235. Any input on this is greatly appreciated! Thanks so much!

Per the NCCI edits removal is included in the placement so it is not separately billable:

"Intubation of the GI tract (e.g. percutaneous placement of g-tube) includes subsequent removal of the tube. CPT codes such as 43247 should not be reported for routine removal of previously placed therapeutic devices."

(you can find it in the Correct Coding Policies at the beginning of the 40000 series)